CMS Price Transparency Data

Psychotherapy session (45 minutes)

Facility: Forks Community Hospital

Billing Code: 90834 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90834
Insurance Median: $104
Cash Discount Price: $161
vs. Medicare Baseline: 0.57x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (45 minutes) at Forks Community Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.57x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$161

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)

Cash / Self-Pay: $161 (89%)

Insurance Median: $104 (57%)

Cash: $161 (89% of Medicare)

Ins. Median: $104 (57% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Coordinated Care (Mco) Mcd-All Plans	$66 - $75	36%
Medicaid / KanCare	$66 - $74	36%
UnitedHealthcare	$66 - $129	36%
Community Health Network Mcr-All Other Plans	$90 - $107	50%
Humana	$90 - $93	50%
Tricare	$90 - $94	50%
Triwest-All Plans	$90 - $93	50%
Molina Commercial-All Other Plans	$93 - $185	51%
Va-Ihs - All Plans	$93	51%
Cigna	$99 - $210	55%
Blue Cross Blue Shield	$104 - $191	57%
Ambetter / Centene	$105 - $108	58%
Wellcare Med Adv - All Plans	$105 - $108	58%
Medicare (plans)	$107 - $318	59%
First Choice-All Plans	$112 - $201	62%
Regence-All Other Plans	$116 - $262	64%
Aetna	$117 - $249	65%
Community Health Exchange	$126 - $131	69%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $161.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90834.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Forks Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90834.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.